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Federal officials cap fines for not buying health insurance

Ron Johnson, Paul D. Clement, Rick Esenberg

FILE - In this Jan. 6, 2014 file photo, Sen. Ron Johnson, R-Wis., joined by attorneys Paul D. Clement, far left, and Rick Esenberg, second from left, announces that he has filed a lawsuit to block the federal government from helping to pay for health care coverage for members of Congress and their staffs during a news conference on Capitol Hill in Washington. A federal judge will hear arguments this week on whether to toss a U.S. senator’s lawsuit challenging rules that force congressional members and their staffs to obtain government-subsidized health insurance through small business exchanges. Johnson contends that senators, representatives and their employees aren’t eligible for the exchanges under the federal health care law because they work for a government that employs millions. He also argues that premium subsidies that congressional members and staffers receive will foster resentment among his constituents. (AP Photo/J. Scott Applewhite, File)
(J. Scott Applewhite)

MIAMI -- Federal officials have capped the amount of money scofflaws will be forced to pay if they don't buy insurance this year at $2,448 per person and $12,240 for a family of five.

The amount is equal to the national average annual premium for a bronze level health plan. But only those with an income above about a quarter of a million dollars would benefit from the cap. Those making less would still have to pay as much as 1 percent of their annual income.

The penalty for the first year starts at $95 per adult or $47.50 per child under 18. The penalty for not buying insurance increases to 2 percent of income or $325, whichever is higher, for 2015. The fines are due when people file their 2014 taxes.

The figures, released late Thursday, are important because the White House has only provided theoretical caps in the past. Conservative lawmakers and groups that are critical of the Affordable Care Act encouraged consumers to skip buying insurance, arguing it would be cheaper to pay a $95 penalty, but often failed to mention the 1 percent clause.

The uninsured will owe 1/12th of the annual payment for each month they or their dependents don't have either coverage or an exemption, according to the IRS.

Federal researchers predict that about 4 million people, including dependents, could be hit with fines by 2016. The Congressional Budget Office had previously projected 6 million would pay fines, but dropped the estimate because more people will be exempt from the law, partly due to changes in regulations.

More than 8 million people signed up for insurance under the Affordable Care Act and many Americans already had insurance through their employers and were not affected by the fine.

If someone is due a tax refund, the IRS can deduct the penalty from the refund. Otherwise, the IRS will let people know what's owed or hold back the amount of the penalty fee from future tax refunds, but there are no liens or criminal penalties for failing to pay.

Some residents, including prison inmates, are exempt from the penalties and others can file for hardship conditions. If people don't earn enough money to have to file a federal tax form, they don't have to buy coverage. The threshold for filing a federal tax return is $10,150.

Premium prices vary widely based on age, gender and zip code so the premium for a bronze plan in South Florida could be much different than the cost of a bronze plan in Kansas.